5
Most people are covered by some type of health insurance. Five years ago very few would have been covered, especially in rural areas. Coverage declines a little for the oldest cohort. No big difference between men and women.

6
NCMS is the largest form of insurance. Followed by urban employee medical insurance. Urban resident medical insurance is the least significant.

8
Higher education positively related to having insurance; Higher income positively related to having insurance; Widowed men much less likely to be insured; Migrants much less likely to be insured, by 15% points

9
Higher education positively related to having insurance; Widowed women much less likely to be insured; Migrants much less likely to be insured; As for men, Rural Gansu MORE likely to be insured. Local community factors matter a lot

10
INSURANCE TYPES

11
Urban hukou: urban employee insurance is the largest type of insurance Rural hukou: NCMS is the dominant insurance Urban area: a lot of residents with rural hukou

12
Similar patterns as men

13
NCMS is not associated with education or incomes; Widowed men much less likely to be insured; Migrants much less likely to be insured; Rural Gansu MORE likely to be insured. Local community factors matter

14
NCMS is associated with literacy but not incomes; Migrants much less likely to be insured; Rural Gansu MORE likely to be insured.

15
SERVICE UTILIZATION

16
Women use outpatient care more frequently.

17
Outpatient service for men is associated with education and to a lesser degree incomes; Rural Gansu more likely to use outpatient care.

18
Outpatient service for women is strongly associated with incomes; Rural Gansu more likely to use outpatient care. Local community factors matter

19
Relatively few people used inpatient care; Not much difference between men and women.

20
Inpatient service for men is strongly associated with incomes; Urban Gansu more likely to use inpatient care.

21
Inpatient service for women is strongly associated with incomes; Gansu more likely to use inpatient care.

22
KEY PARAMETERS OF INSURANCE

23
Insurance premiums are very low in rural areas of Zhejiang and Gansu yuan per year compared to average rural annual expenditures of 3,800- 7,500 RMB; In urban areas, premiums are higher, but still affordable compared to annual expenditures of 7, ,000 yuan In Zhejiang about 1 in 5 elderly persons don’t have to pay any premium; premiums are also lower than Gansu.

24
Inpatient Out of Pocket Shares: By Residence OOP cost shares are much lower in urban areas than in rural areas, reflecting the much higher insurance premiums in urban areas. OOP cost shares are much lower in Zhejiang than in Gansu.

25
Inpatient Out of Pocket Share: By Hukou The urban-rural contrast is sharper if we use the hukou distinction, especially in Zhejiang province.

26
OOP shares are much higher for outpatient care than inpatient care; Reimbursement rates are higher in urban than in rural areas; Reimbursement rates are higher in Zhejiang than in Gansu.

27
Among rural hukou holders, outpatient reimbursement rates are very low; this reflects the design of NCMS Urban Zhejiang has the highest reimbursement rate for outpatient care.

28
Out-of-pocket shares are strongly associated with locations. No SES gradient is observed.

29
OOP shares are strongly associated with locations. No SES gradient is observed.

30
Summary: Descriptive China achieved almost universal insurance coverage in about 6 years Reimbursement rates are much lower than in industrial countries, but much higher than they have been recently in China The new urban and rural insurance is mostly designed to reimburse inpatient care expenses Recent improvements have included coverage of chronic illnesses

31
Summary: SES Correlations Insurance coverage has some SES correlations even within communities Utilization of health services has strong SES correlations But not much SES correlation with reimbursement rates, which is arguably a sign that rules apply to everyone regardless of SES Important community differences exist in almost all aspects, even within provinces